Fulbrighter Teaching Nursing Educators in Kazakhstan

It was during the welcome reception at ambassador Orecks’ residence in Finland that my host university liaison off-handedly mentioned that perhaps I might want to go to Kazakhstan with him later in the fall to help teach the nursing educators there about simulation technology. I quickly and energetically said yes, not realizing how serious he was. By the time I had returned home that night he had emailed telling me of the good news. The director of the program at Laurea University of Applied Sciences in Hyvinkää, Finland had approved me to tag along. Little did I know at the time of the breadth of the project.

I spent the first six weeks at Laurea helping to write the curriculum and create numerous presentations for our two-week program in Kazakhstan. Our first week was in the nation’s former capital, Almaty, in the south of Kazakhstan. We were tasked with demonstrating various well-being technologies that are in use around the world for the care of elderly patients. Included also were training and educational technologies that the educators could use back at their home colleges. Our students were physician-trained nursing educators representing six medical colleges that are piloting a new bachelor’s level nurse training program. The first of the new BSN enrollees occurred this fall. This is a huge step forward for healthcare in Kazakhstan. At the direction of the Kazakh Ministry of Health, the World Bank and numerous other international consultants, with Finland leading the movement, nursing has begun a rapid evolution. The aim is to elevate the level of the nurse from something more than a minimally educated physician’s servant to that of an independent, highly trained and autonomous thinker. No small project. We were in Kazakhstan to be a part of that, which felt a bit nerve-wracking to say the least.

For our second week we flew to the more northern regions of the Kazakhstan steppe to the rapidly growing and relatively new national capital of Astana. Its history is being created each day as hundreds, if not thousands, of new buildings are part of ongoing construction. With a population of about 700,000 it is frantically trying to prepare to host the 2017 International Exposition where the city’s population will likely blossom to five or six times its current level. After a quick night in the capital we traveled by train three hours further north to a smaller but sprawling town of Kokshetau. The lack of mountains and trees in the north made for a frigidly cold, wind whipped week on the Kazakh steppe. Though a city evolving as a take-off point for oil, gas and mineral exploration, its medical college boasts one of the fastest growing and most advanced medical simulation centers for nursing. Nearly a dozen new rooms were being renovated to house the latest in simulation technology ranging from robots that birth newborns to CPR simulators and other high fidelity, full size patient simulation manikins. Their educators and director seemed quite committed to the project and as such were likely some of the most highly advanced simulation experts in all of Kazakhstan.

The goal of our second week, again attended by representatives of the six colleges involved in the rollout of the new bachelor’s curriculum, was how to integrate simulation learning pedagogy more effectively into this new curriculum. Though more or less the standard in the EU and North America this approach is relatively new in Kazakhstan and our task was to help expand their repertoire and knowledge base.  The energy of our students was far from cold though. They were kind, sweet, and quite talkative when given the chance and they showed a real commitment to the project. We constantly heard about the many challenges that they faced in light of the rollout of the new bachelors curriculum. Others included lack of pay, lack of training, lack of respect from physicians and a general lack of expectation from nurses throughout their culture. The teachers told us that nurses need to be empowered to think on their own and that they are too used to just taking orders and need to mature as a profession. These issues are not new to the nursing profession and even in the most progressive professional circles nurses still struggle with many of the same issues. Kazakhstan however is just beginning to embark on this journey. The educators are cautiously optimistic but realize the gravity of such change and that they shoulder much of the responsibility of change. The ministry of health and directors of the pilot colleges seem to believe that by the end of 2016 forward progress will be noticeable. While I think that changing the way a culture perceives nursing will likely take a bit longer than a single run through of a new degree program, I am impressed with their tenacity in the pursuit of this project and proud to say that I was, if for only a short time, a part of this project.

Bradley Boehringer
U.S. Fulbright Graduate Student at Laurea University of Applied Sciences 2014-2015